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Effect of one session of ER:YAG laser ablation plus topical 5Fluorouracil on the outcome of short‐term NB‐UVB phototherapy in the treatment of non‐segmental vitiligo: a left–right comparative study
Author(s) -
Anbar Tag S.,
Westerhof Wiete,
AbdelRahman Amal T.,
Ewis Ashraf A.,
ElKhayyat Mohamed A.
Publication year - 2008
Publication title -
photodermatology, photoimmunology and photomedicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.736
H-Index - 60
eISSN - 1600-0781
pISSN - 0905-4383
DOI - 10.1111/j.1600-0781.2008.00385.x
Subject(s) - medicine , vitiligo , dermabrasion , ablation , hyperpigmentation , er:yag laser , dermatology , surgery , laser , physics , optics
Background: NB‐UVB phototherapy is a very important modality in treating vitiligo but the treatment course usually exceeds 1 year. Skin ablation with mechanical dermabrasion with 5Fluorouracil (5FU) was introduced to treat vitiligo in 1983. This was modified replacing the mechanical dermabrasion by erbium‐YAG (ER:YAG) laser ablation and resulted in better prognosis in periungual vitiligo. Purpose: In the present study, we are exploring the effect of the use of ER:YAG laser skin ablation and application of 5FU on the outcome of short‐term NB‐UVB therapy for patients with non‐segmental vitiligo (NSV). Methods: This study included 50 adult patients with a total of 65‐paired symmetrical NSV lesions in different body parts. One side was treated with ER:YAG laser ablation, followed by 5FU application before simultaneous NB‐UVB therapy of both sides for a maximum period of 4 months. The outcome was then evaluated both qualitatively and quantitatively. Results: The overall response to therapy was better using the combination therapy. Fifty patients (78.1%) experienced a moderate‐marked repigmentation response in the combination group compared with 23.4% in the mono‐therapy group. The response was significantly higher when using the combination therapy in different body parts ( P value is <0.05), except for feet lesions, which were better but not statistically significant ( P value=0.15). Tolerable pain during ablation or at sites of 5FU application was reported in all cases. Transient hyperpigmentation occurred in 30% of cases and 3.1% of lesions healed by a transient slate blue color. Half of the treated periungual lesions showed a temporary tiny brownish spot on nail plates and Köebnerization was not detected in any patient. Conclusion: We concluded that prior use of ER:YAG laser skin ablation, followed by 5FU application before NB‐UVB phototherapy for vitiligo is a safe and tolerable technique that improves the outcome of short‐term NB‐UVB therapy and is expected to increase patient compliance.